Vaping habits may be dipping but non-smoking advocates urge action

Blowing vapor from an e-cigarette at a San Francisco lounge. Photo: Justin Sullivan/Getty Images

More adults may be giving e-cigarettes a try, but fewer people are making it a habit, according to research published in Journal of the American Medical Association Tuesday.

Why it matters: E-cigarettes often contain the addictive ingredient nicotine and other substances that the Surgeon General says may be dangerous, particularly to young people. Non-smoking advocates say the prevalence drop is encouraging, but the government still needs to mandate further research and curb teenage usage.

"Nicotine has adverse effects on cardiovascular system; specifically, it increases heart rate and blood pressure and induces abnormal heart rhythms... it increases the risk of adverse pregnancy outcomes, and it crosses the placenta and negatively affects fetal brain development."

— Study author Wei Bao, of the University of Iowa, tells Axios

By the numbers: The research published Tuesday is an analysis of National Health Interview Survey data on e-cigarette use by U.S. adults in 2014–2016. Out of the roughly 32,000–37,000 people they surveyed each year, they found:

The number of people who tried e-cigarettes grew — 12.6% in 2014, 13.9% in 2015 and 15.3% in 2016.

But, the number who kept using e-cigarettes kept dropping — 3.7% in 2014, 3.5% in 2015, and 3.2% in 2016.

"The decline in current use but increase in ever use in e-cigarettes may suggest that some individuals are trying but not continuing use of e-cigarettes. However, it might be too soon to draw e-cigarette usage trends from just three years of data," Bao says.

Yes, but: Dennis Henigan, VP for legal and regulatory affairs at the Campaign for Tobacco-Free Kids, says the lower rates of usage in youth may be due to Juul becoming such a strong brand (like ubering, Juuling has become its own verb) that kids don't think of it as being applicable to surveys on "e-cigarettes."

He pointed to a Truth Initiative survey that found 63% of Juul users don't realize all have nicotine in them — each cartridge contains an entire cigarette pack's worth of nicotine.

What FDA says: They cannot comment on the lawsuit (the agency's legal response in court is expected by May 29), but a spokesperson says the agency is concerned about the impact on youth and is taking some measures to make tobacco products less toxic and appealing, especially for youth.

Industry response:

Juul says it's implementing its recently announced comprehensive strategy to combat underage use of its products.

Tony Abboud, Vapor Technology Association executive director, tells Axios a decline in youth use is a “top priority" for VTA.

As for adult use, he says: "Given the misinformation and fear tactics employed by so-called U.S. public health groups, it should not be surprising that some smokers are being scared away from e-cigarettes."

Go deeper:

This piece sums up the lawsuit against the FDA and some studies examining pod flavors.

The Washington Free Beacon reports on congressional Democrats circulating a petition to ban pod flavors like chocolate and cotton candy.